OF THE TEETH The eruption of the teeth frequently occurs without causing the least distress to the infant. On the other hand, we also observe dentition preceded and attended by more or less definite symptoms, which point to a local or general disturbance of the infantile organism. Two extreme views in regard to the significance of these symptoms are extant: one maintains that dentition is purely- a physiological phenomenon and does not induce any alteration in the feelings of the infant, and that any disturbance in health during dentition must be regarded as the symptoms of another disease coincident accidentally with the eruption of a tooth. The other view goes so far as to attribute severe morbid conditions (diarrhom, convulsions) to tbe process of dentition. The latter view agrees with that of the older physicians, while the former is a blunt contradiction.
It is out of the question, that the presentation of the newer views to the public can have but a wholesome effect; for with the welcome conception "teething," much evil certainly has been accomplished, inasmuch as other febrile conditions, which had nothing to do with dentition (as disease of the middle car, the intestine, the lung, etc.), re ceived no attention as they were considered temporary and favorable symptoms of teething. Yet the newer view absolutely does not agree with practical experience. What else can the physician do but attribute the symptoms to dentition wrhen, as is often the case, a perfectly normal infant during the eruption of a tooth becomes very irritable, languid and depressed; when its desire to drink is lessened; when the thermome ter indicates febrile movement, when, furthermore, the local inspection of the mouth shows a slight redness and swelling over a growing tooth,— all symptoms rapidly- disappearing with the eruption of the tooth,—and when a careful physical examination of other organs shows only normal conditions? The peevish disposition, the languor, the restless sleep (starting in sleep), the lack of appetite, an elevation of temperature (especially in the evening) and a simple stomatitis attended with drooling,—these are the common symptoms which assist in building a disease under the name of "difficult dentition." In some cases, in addition, vomiting
and diarrMea occur. Moreover, the occurrence of genuine eclamptic seizures has been observed in some infants during the period of teething and never afterward.
While no one would try to find an immediate causal connection between the eruption of a tooth on the one hand and diarrhcra on the other, these disturbances may be readily explained by the experience, that the tender infantile organism may react in manifold ways to a sensible irritation, and to these undoubtedly belongs a painful dentition.
Since these symptoms depend on dentition, they have a fleeting existence and do not, therefore, require any special treatment. While the lancing of the gunis probably has no advantage, brushing of the affected parts with aneson in order to diminish the local pain may be recommended.
Varieties of Dentition.—The time and order of the eruption as well as the process itself, may show variations from the normal. Occa sionally infants are born with teeth (dentitio preeeox), which generally drop out spontaneously or as a consequence of local inflammation. This freak of nature belongs to the rare curiosities and, therefore, possesses no practical importance. On the other hand, dentitio larda, the late eruption of teeth, is important, since it is the most frequent symptom of rachitis. The first milk teeth may- appear at the close of the first year or at the beginning of the second and not at six or eight months. If the rachitis arises late, the first incisors may appear at the proper time, but a long interval follows and the length of dentition is prolonged far beyond the normal. This delay in dentition is even inore characteristic of infantile myxoederna, a disease which is closely related to rickets.